12750 SW 135TH AVENUE I
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CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-O-Phone). 639 75 Business Phone: 639-4171
!nspection:
lei z1r
Footing Susp. Ck4ing Sprink, Rough-in Appr/Sdwlk
Foundation Plbg. Underslab Mech. Rough-in Fireplace
Post/Beam Struct. Plbg. Top Out Elec. Rough in FINAL:
Post/Beam Mech. San. Sewer Gas Line -Bldg.
Plbg. Underfloor Rain Drain Framing -Plumb.
Alarm Water Line Insulation -Meeh.
Underflr. Insul. Shear Wall Gyp. Bd. -Elect.
Date Requested �� Time: AM PM
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Address:
Builder: _Permit
THE FOLLOWING CORRECTIONS ARE REQUIRED:
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�nLptor: _ l -- / Date:_ ?L--
PROVED ____DISAPPROVED —APPROVED SUBJECT TO ABOVE
___-Call For Reinsp.
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November 15, 1994
Signet Development
1810 Twin Points
Lake Oswego, OR 97034
12780 SW 135TH AVE, SEWER PERMIT #SWR93-0335
On 7/21/93 we issued a permit for this project, however, we have no record
of any inspection being completed.
�rmits become void if there has not beer inspection perforr A for over
180 days. In that case, the Building Divisi,..i may require a new application
and fees to commence or continue work. A notice of non-cor.�pliance against
the property may also be recorded by the City.
Please advise the Building Division within 15 days from the date of this letter
as to the status of this project.
JM
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APPLICATION STREET IMPROVEMENT/EXCAk ATIONCOPY TO:
ORDINANCE NO. 74-14 C�,�, ri (WHITE)-FILE
(YELLOW)-INSP.
"C— (PINK)-OTHER AGENCYbiCig-
(INSTRUCTIONS ON SEPAFZAT17 SHEET) i� (EILUE)-APPLICANT
APPROVED ® L APPLICATION NO.: I�
NOT APPROVED ❑ C,II Y OF TIGARD, OREGON FEE AMT.: s 40.00
PENDING FEE. PMT, 0 CI('Y HAIL RECEIPT;NQ.: "-1-24303 ?
PENDING SECURITY ❑ PUBLIC WORKS DEPA R rMEN T r BY �.'Ij�J _ DATE__ �-
PENDING AGENCY ''OK'' n 1 — — — — — — — — — —
❑ ((( .Application and roRrrss Record f'
PEN6ING INFORMATION ClK:AINTENANCE BOND
'— FOR STREET IMPROVEMENT/EXCAVATION As s:EcaulNeo `
ANNUAL ❑
PENDING VARIANCE L EXPIRATIOP DATE: L /
PERMIT NO. 561 "'e
- DATE ISSUED: BY:
(1) APPLICATION IS HEREBY MADE TO EXCAVATE FOR AND INSTALL -_ +NzrAxsF IC1 _QCj�(�
& SIDE S&iM SERVICE LINE: AS DESCRIBED HEREIN, IN FULL ACCORDANCE WITH CITY REQUIREM NTS.
636- & vQoice)
APPLICANT Signet Deyelo�xn@nt 1.810 Twin Points Lake oswego, OF! 97034 __'780-2148 (n)=1
NA E ADDRESS CITY PHONE
CONTRACTOR--Seven Gables Contr. _ 246-0586
NAME ADDRESS --~—�—_ CITY ^— �-- PHONE
PLANS BY _= per City Standards & SpeCifieatium
NAME -- —_- ADDRESS —CITv PHONE
ESTIMATED IMPROVEMENT TOTAL VALUATION ( COS-. ): E _1,000.00
DOLLARS
SE:OR OFFICE ysz: ^-CMIN.
(2) EXCAVATION DATA: FOR
x soo=s �40•00
STREET _ DESCRIPTION _PROGRESS & INSPECTION STATUS
NAME SURFACE CUT CUT CUT MATERIAL INSTALLECI ('EM GATE REMARKS/TYPE BY
TYPE LENGTH WIDTH DEPTH ITEM & QUANTITY
�= STREET --
OPENED
" SEE ATIP' ,; I);l-)e I TION - --' --
_ E _
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ESTIMATED STREET OPENING DATE:— E
ESTIMATED STREET CLOSING DATE: T
_. E
11000 STREET
(3) SECURITY NO. _ SECURITYAMT.: CLOSED
SURETY CO.: _ FINAL
CHECK CASH ❑ 01014 '~ INSPEC.
(4) PLOT PLAN: INDICATE SITE PERTINENT PHYSICAL SPECIAL PROVISIONS/CONATIONS:
FEATURES; EXCAVATION LOCATION AND EXTENT. I.. See attached conditions
SITE: 12780 S.W. 135 pe� and details.
work area
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- S.W. 135th AVENUE ln:;. Co. R/W _
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(5) NOTE. THE CITY OF TIGAR[l DOES NOT, HEREBY, GRANT PERMISSION TO APPLICANTS TO CONDUCT WORK WHERE
RIGHT-OF-WAY JURISDICTION IS THAT OF WASHINGTON COUNTY OR THE STATE OF JREGON.
THE APPLICANT AGF)f.ES TO DEP tIT THE REQUIRED SECURITIES, TO COMPLY WITH ALL PER'F(NENT LAWS AND
CONSTRUCTION SPECIFIkATIONS PE TINENT TO CONDUCT OF THE WORK, AND TO SAVE HARMLESS THE CITY AND
EMPLOYEES AGAIN41( ANYI JU Y DAMAGE WHICH MAY RESULT FROM APPLICANTS ACTIONS.
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APPLICANTS SIGNATURE 1 DATE
CITY OF TIGARD
CQMMUNITY DEVELOPMENT DEPARTMENT
13125 SW Hall Blvd.Tigard,Oregon 97223+8199 (503)839-4171
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13123 SW Hallllly& PLNCK/RECT 9
CITY OF T I tJr,C�.1 D PERMIT # _ -
COMMUNFIT DEVELOPMENT DEPARTMENT TIPIAOrcgon M23
(503)63"171 DATE ISSUED
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TAX MAPAO s (b4 QC) �
JOB AD ESS. ^
SUB: OJol �'1z,s LOT: 7.ZnLAND USE:
VALUATION:
OWNER SPECIAL NOTES
NAME: L 1T PM JZ REISSUE OF: _
`J ADDRESS: ( ((� ^� ` LAST REISSUE: —
_ FLOOD PLAIN/
PHONE: SENSITIVE LAND:
CONTRACTOR APPROVALS REQUIREO
NAME: PLANNING:
ADDRESS: ._ ENGINEERING: - _-
FIRE DEPT: _ _--
PHONE: -_-- OTHER: _ _ ---
CONTR. BOARD #: EXP DATE:
ITEMS REQUIRED
SUBCONTRACTORS: PLUMB: LIST/SUBCONTRACTORS:
MECH: - BUS TAX:
ARCH/ENGINFFR CALCULATIONS: -
NAME: _-- - ---_T---__---- _ TRUSS DETAILS:
ADDRESS: OTIIER: --- -
PHONE: - - - -- - - _ -----
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PROPOSED BLDG. USE: ----------- --- - --
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COMMENTS: --- --
AHLICANT SIGNATURE
Received By: ___� _ Date Received: _
PERMIT k ACCT ,4 DESCRIPTION AMOUNT AMOUNT PD. BAS_. DUE
_ 10--432 00 Building Permit Fees
_= 10-431 00 Plumbinq Permit Fees —
_ 10-431 01 Mechanical Permit lees _
10-230 01 State Building Tax (5x) _
Building
Plumbing
Mechanical
10-433 00 Plans Check Fee
Building
Plumbing _
Mechanical
10-230 06 Fire
30-202 00 Sewer Connection
30-444 00 Sewer Inspection
25-448-02 Commercial TIF Fees
2.5-448-04 In..usteial TIF Fees
25-448--06 Institutional TIF Fees
2.5-448-03 Office TIF Fees
25-448-01 Residential Traffic Fees
25-448--05 Mass Transit TIF Fees
52-449 00 Parks System Oev Charge (PUC)
31-450 00 Stogy-m Drainage Syst Oev Chrg
(SSDC)
Ce 24-445-01 Water Quality (Fee in lieu of)
Ln 2.4-445-02 Water Quantity (Fee in lieu of)
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SE1Yu SEIYU INTERNATIONAL
:ISL: (503)245-4090•(503)245-4435 PAX(503)245-4351
date :
—
To. whom it may concern; —
has contributed to our satisfaction on the public sewer line that
we have installed on 135th Avenue, Tigard .
Project # 89340
Summit at bull Mountain, Phase i
This letter is to serve as a "Letter of Participation" concerning
the above public sewer line project .
Sincerely,
Kurt Var'/olkenburgh
C1. General Manager
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Lincoln Center 10220 S.W.* Greenburg Suite 450 Portland, Oregon 97223
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CONSENT COVENANT (NONREMONSTRANCE AGREEMENT)
ANNEXATION
The undersign owners (including purchasers) *6f the real pro e
P t-ty
described below do hereby record their consent to annexationito the
City of Tigard. The undersigned expressly waives all present and
future rights to oppose or remonstrate against annexation oto the
City of Tigard,
The real property that is the subject of this consent covenant is
described as follows:
Part. of Lot 32, handy Acres, Washington County, Oragon, cor.-ionly
known as lot # 3300, Washington County Tv: Map 2S1 04BD
IN -WITNESS WHERE, the grantor has hereunto set his/her hand a
seal .�h�s ._/ day of _ <_'7 0 L•3Ei� I9 0� '..
SIGNED " SIGNED
MARYLAIM
STATE or = ) j
Harford
County of W �tii:gzc�z y !
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BE IT REMnnERED, that on this 16th day of October �,
19 92 , this instrument was freely and voluntarily executed before
me,, the undersigned notary Public in and for the State of Oregon,
by Robert L. Poole and Linda M. Poole
IN TESTIMONY WHEREOF, I have hereunto set my hand and. seal.
this _ 16th day of . October 19 92 . I
No a. /Pu2oli.c f 0171fMAR�'LAND
(NOT- RIAL SEAL) MV Commission E ices: 4.;01-93
a GRANTOR'S NAME/ADDRESS
Robert L. Poole/Linda M. Poole
111 Crescent Drive l
Bel Air, Maryland 21015
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. BR/N011REMON.NST � .